Knowledge and perception of nuclear medicine by radiologists in French-speaking sub-Saharan Africa.

OBJECTIVES: to assess the knowledge and perception of nuclear medicine by radiologists in French-speaking sub-Saharan Africa. METHODS: cross-sectional study conducted from April 8 to June 7 2020 including radiologists practicing in French-speaking sub-Saharan African countries. Data were collected electronically via a google form. RESULTS: Of the 142 radiologists surveyed, 45.8% had already completed an internship in Europe, 3.52% in a nuclear medicine department and 72.54% had a nuclear medicine department in their country of practice. Among these radiologists, 21.13% knew the three main techniques of nuclear medicine and only 9.15% knew that nuclear medicine allows functional, metabolic and molecular studies. On average, 56.8% were aware of clinical indications for the main fields of nuclear medicine. In 47.18% of cases, they thought that scintigraphic imaging was more irradiating than radiological imaging, 71.1% knew about hybrid imaging techniques, 43.66% had read a scientific article on nuclear medicine, 4.93% had attended a nuclear medicine conference and 28.9% had recommended a scintigraphic imaging examination in their report. Half of them would like to see nuclear medicine and radiology merged into a single specialty and 95.77% considered it essential to create a nuclear medicine department in their country. CONCLUSION: The level of knowledge of radiologists in French-speaking sub-Saharan Africa about nuclear medicine was, on the whole, unsatisfactory with a generally encouraging perception.

Knowledge and attitudes of ultrasonography physicians regarding the biological effects of ultrasound in French-speaking sub-Saharan Africa.

OBJECTIVE: To assess the knowledge and practical attitudes of ultrasonography physicians regarding the biological effects of ultrasound in French-speaking sub-Saharan Africa. MATERIALS AND METHODS: A descriptive cross-sectional study carried out over a period of 03 months (from 1st August to 31st October 2019) which included doctors carrying out ultrasound examinations in French-speaking sub-Saharan African countries via an electronic survey form. RESULTS: The 137 ultrasonography physicians came from 13 different countries and included 58% radiologists, 15% gynecologists, 14% cardiologists and 13% general practitioners. The majority of ultrasonography physicians had less than 10 years of professional experience (87.60%) and performed more than 25 ultrasonographies per week (65.69%). The biological effects of ultrasound were known by 69.34% of ultrasonography physicians. Only 44% were able to cite the two biological effects of ultrasounds; 59.13% were unaware of the existence of thermal and mechanical indexes and 66.42% had no idea about the normal values of these indexes. They were unaware that their devices showed mechanical or thermal index in 48.91% of cases, consulted these indexes at the beginning of ultrasound explorations in 26.92%, and had no idea about the practical attitudes to adopt in the face of an increase in these indexes in 54.74% of cases. Half of the gynecologists and general practitioners and 55% of the radiologists affirmed that they avoid using Doppler as much as possible to explore the embryo. CONCLUSION: The level of knowledge of ultrasonography physicians about the biological effects of ultrasound was unsatisfactory in French-speaking sub-Saharan Africa and good attitudes to ultrasound safety were not always adopted.

Dosimetry of pediatric chest X-Ray examinations in Togo.

OBJECTIVE: To assess the entrance surface dose (ESD) of pediatric chest X-ray examinations in order to establish a diagnostic reference levels (DRLs) in Togo. MATERIALS AND METHODS: The study was carried out in 13 radiology departments within the 6 health regions of the country. This is a descriptive cross-sectional study relating to the dosimetric assessment of the skin of children aged from 0 to 15 years during chest X-ray examinations. The assessment was made by the empirical formula calculation of the entrance surface dose (ESD = 0.15 × (U/100)2 × Q × (1/FSD)2) and with the Internet Dose Calculation Module (MICADO) software online. Statistical assessment was performed using IBM SPSS 21 software. RESULTS: Our sample numbered 390 with a sex ratio of 1.3 and predominantly male. Examinations performed with the analog radiography units were more irradiating (0.14 mGy) than ones performed with digital detectors (0.12 mGy). The mean dose calculated with MICADO was low (Avg. = 0.12 mGy) compared to that calculated with the theoretical method (Avg. = 0.16 mGy). No significant relationship was found between the professional experience of operators and the entrance surface dose (r  > -1 with p = 0.146 not significant). MICADO doses increased with age. The values of the diagnostic reference levels used for the antero-posterior or postero-anterior chest X-ray examinations for children aged 0-1 year; 1-5 years; 5-10 years and 10-15 years were respectively, 0.15 mGy; 0.14 mGy; 0.15 mGy and 0.17 mGy. CONCLUSION: The entrance surface dose varied greatly from one health facility to another for this same examination. In most of the different age groups of children, the diagnostic reference level was higher than that found in literature. Thus, effective measures must be put in place to optimize the doses delivered to children during chest X-ray examinations.

Usage des Rayonnements ionisants en milieu médical à Cotonou (Benin)

Objectif : Faire l'état des lieux des applications médicales des rayonnements ionisants dans la ville de Cotonou.Matériels et méthode : Etude prospective du 16 avril au 22 juin 2018 dans les structures sanitaires disposant de générateurs ou sources de rayonnements ionisants utilisés à des fins médicales dans la ville de Cotonou. Les paramètres étudiés étaient : les caractéristiques des structures sanitaires utilisant les rayonnements ionisants, les infrastructures techniques et ressources humaines impliquées, et la mise en oeuvre des mesures de radioprotection.Résultats : Les rayonnements ionisants étaient utilisés respectivement dans 22 services pour les rayons X, et 1 service pour les rayons gamma. Ces services ne couvraient que les 2/3 des arrondissements. Les générateurs de rayons X comprenaient les appareils de radiologie classique (52,1%), de mammographie (19,6%), de radiologie dentaire (15,2%) et de scanner (8,7%). Ces appareils étaient acquis à l'état neuf dans 52,1% et utilisés dans 63,1% dans les structures privées. Ils étaient dominés par les marques Siemens (20,8%), Schimadzu (12,5%) pour la radiologie classique. Les scanners avaient un âge compris entre 5 et 9 ans et étaient de 16 barrettes dans 50%. Quatorze radiologues et 65 manipulateurs étaient recensés. Près des 2/3 des manipulateurs avaient moins de dix années d'expérience. Aucune structure n'utilisait de dosimètre. Seulement 2 structures sanitaires disposaient de pictogramme et de règlement de zone. Un peu plus de 1500 patients étaient exposés aux rayons X par semaine et 150 dosages radio immunologiques étaient réalisés par semaine.Conclusion : L'usage des rayonnements ionisants était exclusivement à but diagnostique à Cotonou avec des mesures de radioprotection peu satisfaisantes

A low-cost tele-imaging platform for developing countries.

PURPOSE: To design a "low-cost" tele-imaging method allowing real-time tele-ultrasound expertise, delayed tele-ultrasound diagnosis, and tele-radiology between remote peripherals hospitals and clinics (patient centers) and university hospital centers (expert center). MATERIALS AND METHODS: A system of communication via internet (IP camera and remote access software) enabling transfer of ultrasound videos and images between two centers allows a real-time tele-radiology expertise in the presence of a junior sonographer or radiologist at the patient center. In the absence of a sonographer or radiologist at the patient center, a 3D reconstruction program allows a delayed tele-ultrasound diagnosis with images acquired by a lay operator (e.g., midwife, nurse, technician). The system was tested both with high and low bandwidth. The system can further accommodate non-ultrasound tele-radiology (conventional radiography, mammography, and computer tomography for example). The system was tested on 50 patients between CHR Tsevie in Togo (40 km from Lomé-Togo and 4500 km from Tours-France) and CHU Campus at Lomé and CHU Trousseau in Tours. RESULTS: A real-time tele-expertise was successfully performed with a delay of approximately 1.5 s with an internet bandwidth of around 1 Mbps (IP Camera) and 512 kbps (remote access software). A delayed tele-ultrasound diagnosis was also performed with satisfactory results. The transmission of radiological images from the patient center to the expert center was of adequate quality. Delayed tele-ultrasound and tele-radiology was possible even in the presence of a low-bandwidth internet connection. CONCLUSION: This tele-imaging method, requiring nothing by readily available and inexpensive technology and equipment, offers a major opportunity for telemedicine in developing countries.